Management of an 11-week cesarean scar pregnancy
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"Introduction: Cesarean scar pregnancy is a life-threatening condition, especially in the advanced gestational age. Optimal management has not yet been established because this is a rare condition.
Case Report: A 30-year-old female, with a previous cesarean, diagnosed with a viable cesarean scar pregnancy with 11 weeks of gestation. Successful termination of cesarean scar pregnancy was achieved with systemic and local (ultrasound-guided) methotrexate administration with subsequent dilatation and evacuation, under ultrasound guidance, in a two- stage procedure: rupture of the amniotic sac with partial removal of the fetus and one week later total evacuation of uterine content, with satisfactory hemostasis.
Conclusion: Cesarean scar pregnancy is associated with a high morbidity and adverse consequences for future fertility. There is no optimal management established, because of the rarity of the condition. We present a case of successful termination of an advanced first trimester cesarean scar pregnancy. "....

http://www.edoriumjournals.com/journal-of-case-reports-and-images-in-obstetrics-and-gynecology/archive/2015-archive/100004Z08SR2015-rocha/100004Z08SR2015-rocha-full-text.php
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